Enlargement of cerebral third ventricle in psychotic patients with delayed response to neuroleptics.
Enlargement of the cerebral third ventricle appears to be a replicable finding in groups of patients with psychotic illnesses, and there is evidence for an association of third ventricle enlargement with poorer response to treatment. Third ventricle area and width were measured from computed tomography (CT) scans in 24 mood-incongruent psychotic patients and 14 controls age and gender matched to schizophrenic patients. Patients were treated with a fixed dose of haloperidol and classified as rapid responders (55% symptom reduction on New Haven Schizophrenic Index (NHSI) within 4.5 +/- 1.3 days) or delayed responders (55% symptom reduction on NHSI within 18.6 +/- 10.5 days). The significant enlargement of third ventricle area was isolated among the 12 delayed neuroleptic responders (19.3 +/- 9.0 mm2) compared with the 14 controls (11.7 +/- 4.8 mm2, p = 0.01), and 12 other mood-incongruent psychotics. Third ventricle width also showed a trend towards larger width in the delayed responders. There was a clear positive correlation between ventricular size and patient's age exclusively in the delayed responders (r = 0.78); a comparable relationship between ventricular size and age was not present in controls, or in the other psychotics. This finding is consistent with an age-related progressive degenerative process in the central nervous system (CNS) isolated to the neuroleptic-delayed responsive psychotics.
Kaplan
M J
MJ
Department of Psychiatry, University of Cincinnati College of Medicine, OH.
Lazoff
M
M
Kelly
K
K
Lukin
R
R
Garver
D L
DL
D000328:Adult; D000341:Affective Disorders, Psychotic / Q000000981:diagnostic imaging / Q000188:drug therapy; D000367:Age Factors; D002552:Cerebral Ventricles / Q000187:drug effects*; D014695:Cerebral Ventriculography / Q000187:drug effects; D005260:Female; D006220:Haloperidol / Q000627:therapeutic use; D006801:Humans; D008094:Lithium / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D011618:Psychotic Disorders / Q000000981:diagnostic imaging* / Q000188:drug therapy; D011930:Reaction Time / Q000187:drug effects*; D012559:Schizophrenia / Q000000981:diagnostic imaging / Q000188:drug therapy; D014057:Tomography, X-Ray Computed; D014149:Tranquilizing Agents / Q000627:therapeutic use*
D014149:Tranquilizing Agents; D008094:Lithium; D006220:Haloperidol